The Study Of Influencing Factors For The Treatment Of Placenta Implantation By High Intensity Focused Ultrasound

Background:Placenta accreta is a benign disease of obstetrics, but its concurrent hemorrhage could cause serious damage to patients' life.It is important for the prognosis of the disease to use early personalized combination therapy. Hysterectomy hurt women's physical and mental health.The conservative treatment can save the uterus,but it can't reduce the complications of intraoperative and postoperative and with lesions residual.HIFU as a noninvasive treatment technology,has gradually been used in the treatment of placenta accreta research and obtained certain effect. This therapy keeps the patients with uterine and has not found serious complications. However,to expand a new technology of indications,we must observe and research its methods, dose, influence factors,security,effectiveness.This paper discusses the influence factors of HIFU treatment of placenta implantation,to improve the effectiveness and safety of HIFU treatment of placenta implantation.Objective:Study the influence factors of of placenta implantation by HIFU treatment.Participants:The 20 patients from Suining central hospital between January 2011 and February 2011 who was made a definite diagnosis of placenta increta by HIFU treatment.The age of patient from 20 to 39 years old and the average age is (28.80-4.66)years old.The preoperative symptoms of the patients had a certain degree of vaginal bleeding. The selected patients had been made ultrasound examination before HIFU treatment and contrast-enhanced ultrasound examination after HIFU treatment.The 18 patients were done uterine curettage after HIFU treatment. Bleeding symptoms of all patients disappeared after one month.Only one patient had numbness and tingling of leg and fully recovered after one month.Methods:The group of A1:average induration diameter<5 cm,8/20;the group of A2:average induration diamete>5 cm,12/20;the group of B1:Depth implanting exceed ahalf,8/20; the group of B2:Depth implanting insufficient a half,12/20;the group of ChBlood flow signal level zero to one,10/20;the group of C1:Blood flow signal level two to three,10/20; the group of D1:with other treatments before HIFU treatment,12/20; the group of D2:without other treatments before HIFU treatment,8/20; the group of El:with natural labor,10/20;the group of E2:without natural labor,10/20.Compare the The energy effect factor and immediate ablation rate of A1 and A2?B1andB2?C1andC2?D1andD2?E1andE2.Results:1.20 patients complete the treatment.The average irradiation time was 931.00 (616.50,1504.25) S, The average irradiation dose was 351214.00 (232650.00,598387.50) J,The average ablation rate of group was 69.50 (59.50,79.50)%,The average EEF was (8.15±13.32) J/mm3.2.Compared group Al and A2, the difference have statistical value (p <0.05). The average ablation rate of group C1 is higher than that of group C2, the difference had statistical value with the average ablation rate (p< 0.05),but the average EEF did not show significant statistical difference. The average EEF of group El is higher than that of group E2, the differ-ence had statistical value with the average ablation rate,but the average ablation rate did not show significant statistical difference, group D1 and group D2?group E1 and group E2 did not show significant statistical difference in the average ablation rate and EEF.Conclusions:1.The blood flow signals and volume of placenta accreta had significant effect on the ablation rate of HIFU treatment.The greater volume and richer blood flow, the ablation rate is lower.2.The volume and the labor of patients have significant effect on EFF of HIFU treatment. The patients of natural labor (cesarean delivery and abortion) have lower EFF. The greater the volume,EFF is lower.